Healthcare Provider Details

I. General information

NPI: 1558453423
Provider Name (Legal Business Name): STEPHEN FEFFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 ARNOLD CT
EAST ROCKAWAY NY
11518-1624
US

IV. Provider business mailing address

26 ARNOLD CT
EAST ROCKAWAY NY
11518-1624
US

V. Phone/Fax

Practice location:
  • Phone: 516-569-8659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number106508
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: